Why Visit Someone with Dementia?

Visiting a friend or relative with memory loss can be daunting. What will you say? What if she doesn't remember you? What if he is inappropriate? If you are taking your child, will she be nervous or scared around the other residents? What about the smell? There are so many potential barriers to a simple visit.

So, take a deep breath, and relax. PLEASE GO VISIT. Period. Perhaps I should change that- exclamation point is better- GO VISIT!! Or pick up the phone, and at least call, if they are able to talk on the phone. Ultimately, that friend or relative will have a better day if you visit. Whether they can carry on a full conversation with you about your high school high jinks together or they have no clue what you are talking about, they are human, complete with the full range of emotions that we all enjoy. Sadly, loneliness and boredom often occupy much of your time when you are suffering from memory loss. People treat you differently, talking to you as if you were less intelligent or perhaps deaf. Even if you don't catch a punch line, you can share a hearty belly laugh with someone.

So, here are a few suggestions for an easier visit:

1. Bring pictures, especially of you and your friend together.

2. Use technology- iPhones, iPads, and laptops are wonderful for sharing pictures or for finding images of special places and events (think the Grand Canyon or the Olympics) to chat about.

3. Music- again, the MP3 players are terrific for finding a tune or a snippit of a song.

4. Avoid food that requires utensils, but finger foods like french fries, or a small ice cream cone can be a delight to enjoy together if conversation is a challenge. (Obviously, check with your friend's caregiver for appropriate food choices.)

5. Consider a "Sunday drive". Often folks enjoy simply getting out and about for a short car ride. Pop on the radio or seasonal music and cruise around for a half hour. Yes, this is expensive in gas dollars, but often well worth the price for the sense of "escape" from the residence.

BOTTOM LINE: Visiting someone with memory loss (dementia) need not seem so stressful- relax, smile, hug, laugh...and your friend will, too. And hopefully, when we are the one with memory loss, our friends and families will return the favor.

Memory Loss Equals Alzheimers?

Alzheimer's disease (AD) should be simple to diagnose, right? How hard can it be for a doctor to decide if memory loss is a normal part of aging, or if it is severe enough to "count" as Alzheimer's? Well, if diseases only occurred one at a time, it might be simple. Unfortunately, as old Texas doc's say, when you itch, it's possible you've got ticks AND fleas. I find in family medicine, it's rare we see any disease state by itself, and Alzheimer's is no exception.

Many different issues can affect memory. Depression and/or anxiety very frequently preoccupy the brain so much that short term memory loss can be a predominant issue. Low thyroid levels can decrease memory. B12 deficiency is another cause. The list of medications that can affect memory seems to be growing each year as well.

When my mother first noticed significant memory issues at the age of 61, she was convinced she had Alzheimer's. I literally laughed when she told me her concerns...We had no family history of early or even late onset dementia. She had recently started a medication known for impairing memory (Digoxin.) As her medical workup progressed, I was relieved to find out she had not only that medication as a possible cause, but literally every cause I listed above- B12 deficiency, hypothyroidism and depression. I felt confident that as we addressed each of these problems, her memory would improve. In many cases, that would have been true, but unfortunately for Mom, she did indeed have underlying Alzheimer's, which took roughly another two years to fully decipher.

If you are concerned about memory loss, please make an appointment with your family physician to address your concerns. Head to the Alzheimer's Association website and review the 10 Warning Signs of Alzheimer's. Until those biomarkers for AD become more refined, physicians will not have a quick or simple answer, but a thorough history and exam, combined with possible neuropsychiatric testing, will take us a long way in the right direction.

BOTTOM LINE: Memory loss can have many different causes, and these causes can and frequently do overlap.

Independence Day, Indeed!

July 4th is a wonderful day in America, filled with family celebrations, picnics and fireworks. We are so fortunate to live in a country that allows us so many freedoms! In our family, this day has additional significance, as today marks the 8th anniversary of my mother's independence from Alzheimer's Disease. As we once again visited her grave today, surrounded by the incredible beauty of the wildflowers and the snow-capped mountains, I looked around the cemetery and wondered how many other lives represented there were affected by this disease.

Did you know we have over 5.3 million Americans living with Alzheimer's? Chances are good that you either have a family member or friend affected. We have medications that can improve some behavioral and cognitive functions in people with dementia, but none yet that can stop or cure it. With our aging population, it is clear that this disease alone will consume a progressively larger chunk of our healthcare dollars.

Check out the Alzheimer Association website, and consider participating in a local Memory Walk or other fundraiser.

BOTTOM LINE: Let's celebrate our country's independence today by thinking about the future of our aging population, and pro-actively working towards a cure for Alzheimer's.

iPads to Prevent Dementia?

When I speak about Alzheimer's disease, people often ask what they can do to help prevent this debilitating illness. Although scientists have looked at innumerable medical interventions such as hormone replacement (estrogen), ginkgo biloba, anti-inflammatory drugs (like ibuprofen), Vitamin E, and many others, we have yet to find the right answer. The best evidence medical trials today suggest that our primary prevention lies in all the health maintenance strategies that prevent heart disease, high blood pressure and diabetes- namely a healthy diet high in vegetables and fruits & low in "junk", plus regular aerobic exercise.

Additionally, many studies have shown some benefit from "cognitive activities", meaning brain exercises, through puzzles such as word games (crossword puzzles or word searches) or number challenges such as sudoku. Is there a way technology might help? Why not? I believe the act of learning new skills in any format will help, regardless of whether it is an old-fashioned crossword puzzle from the Sunday paper, or learning to use... well, yes, an iPad. Let me say now that no, I do not have stock in Apple, though perhaps I should. And, I'm sure any electronic tablet will fit the bill. That being said, let me share our family's personal experience.

We gave my mother-in-law (who looks amazingly younger than her actual age, which I am not allowed to reveal) an iPad 2 for Christmas so that we could "face time" (video chat, for those uninitiated) with her, which would feel more intimate than just a phone call. Although she is very educated (a former RN), she has never had a computer or a cell phone, so we were uncertain how much use she would get beyond this function. May I brag that she is now texting like a teen? She is able to read and follow her favorite blogs, listen to Bible verses, enjoy interactive Rosaries, and best of all, "chat" with us throughout the day. We can text her pictures on the spot, and engage her in our daily lives more easily. As she is eagerly learning these new skills, I can picture those neurons firing up like crazy, and I have to think that her brain is reveling in the new stimulation.

BOTTOM LINE: You're never too old to learn a new skill, and when you do- your brain will thank you!

Visiting Someone with Memory Loss

Visiting a friend or relative with memory loss can be daunting. What will you say? What if she doesn't remember you? What if he is inappropriate? If you are taking your child, will she be nervous or scared around the other residents? What about the smell? There are so many potential barriers to a simple visit.
So, take a deep breath, and relax. PLEASE GO VISIT. Period. Perhaps I should change that- exclamation point is better- GO VISIT!! Or pick up the phone, and at least call, if they are able to talk on the phone. Ultimately, that friend or relative will have a better day if you visit. Whether they can carry on a full conversation with you about your high school high jinks together or they have no clue what you are talking about, they are human, complete with the full range of emotions that we all enjoy. Sadly, loneliness and boredom often occupy much of your time when you are suffering from memory loss. People treat you differently, talking to you as if you were less intelligent or perhaps deaf. Even if you don't catch a punch line, you can share a hearty belly laugh with someone.
So, here are a few suggestions for an easier visit:
1. Bring pictures, especially of you and your friend together.
2. Use technology- iPhones, iPads, and laptops are wonderful for sharing pictures or for finding images of special places and events (think the Grand Canyon or the Olympics) to chat about.
3. Music- again, the MP3 players are terrific for finding a tune or a snippit of a song.
4. Avoid food that requires utensils, but finger foods like french fries, or a small ice cream cone can be a delight to enjoy together if conversation is a challenge. (Obviously, check with your friend's caregiver for appropriate food choices.)
5. Consider a "Sunday drive". Often folks enjoy simply getting out and about for a short car ride. Pop on the radio or seasonal music and cruise around for a half hour. Yes, this is expensive in gas dollars, but often well worth the price for the sense of "escape" from the residence.
BOTTOM LINE: Visiting someone with memory loss (dementia) need not seem so stressful- relax, smile, hug, laugh...and your friend will, too. And hopefully, when we are the one with memory loss, our friends and families will return the favor.

Puppy Love & Alzheimers

This week our family welcomed it's newest member- Tozi (after the Atzec goddess of nature & water), an 8 week old Portuguese water dog (a virtually non-shedding, friendly breed often used as therapy dogs). I want to share a wonderful experience that this young pup has already brought to us. We took Tozi to visit my Dad, who lives in a memory care unit. All of the residents have some form of dementia, primarily Alzheimer's. As we walked in carrying the puppy, we were greeting with smiles, oohs and ahs. Although I was a bit apprehensive about her wiggly body and sharp puppy teeth, I asked if anyone would like to pet her. And did they EVER!

Almost every resident not only wanted to pet her, but asked to hold her. They snuggled her to their chests and chins, encouraging her to give them a "kiss" on their cheeks. I was amazed at Tozi's instinctive, unbelievably CALM response. She went practically limp in their arms, gently raising her head for pats and kisses. One sweet lady balked when we went to remove Tozi from her arms- "Don't rush me! I could hold her and love on her all day!" The joy one tiny six pound pup could bring was immeasurable. I started asking everyone about what pets they had cherished, and all the residents seemed to jump in. One lady had every type of pet you can imagine, and a few I'd never heard of (waltzing mice?!)

Our other dog is a labradoodle, another breed that is often used for pet therapy. Full therapy dog training takes a few years, many courses, and lots of consistent practice. That being said, I believe that a loving snuggle with any cooperative, calm pet goes just as far for most people suffering from dementia. Obviously, you must be careful that the animal does not harm anyone (the lawyers make me add that!) Our pup has already made a second visit, and the smiles & joy keep coming.

BOTTOM LINE: People with dementia are thirsting for love and touch as much if not more than the rest of us. Remember to share some some love & touch- or maybe even some puppy love-on your next visit.

Alzheimer's Disease- Why So Hard to Diagnose?

Alzheimer's disease (AD) should be simple to diagnose, right? How hard can it be for a doctor to decide if memory loss is a normal part of aging, or if it is severe enough to "count" as Alzheimer's? Well, if diseases only occurred one at a time, it might be simple. Unfortunately, as old Texas doc's say, when you itch, it's possible you've got ticks AND fleas. I find in family medicine, it's rare we see any disease state by itself, and Alzheimer's is no exception.

Many different issues can affect memory. Depression and/or anxiety very frequently preoccupy the brain so much that short term memory loss can be a predominant issue. Low thyroid levels can decrease memory. B12 deficiency is another cause. The list of medications that can affect memory seems to be growing each year as well.

When my mother first noticed significant memory issues at the age of 61, she was convinced she had Alzheimer's. I literally laughed when she told me her concerns...We had no family history of early or even late onset dementia. She had recently started a medication known for impairing memory (Digoxin.) As her medical workup progressed, I was relieved to find out she had not only that medication as a possible cause, but literally every cause I listed above- B12 deficiency, hypothyroidism and depression. I felt confident that as we addressed each of these problems, her memory would improve. In many cases, that would have been true, but unfortunately for Mom, she did indeed have underlying Alzheimer's, which took roughly another two years to fully decipher.

If you are concerned about memory loss, please make an appointment with your family physician to address your concerns. Head to the Alzheimer's Association website and review the 10 Warning Signs of Alzheimer's. Until those biomarkers for AD become more refined, physicians will not have a quick or simple answer, but a thorough history and exam, combined with possible neuropsychiatric testing, will take us a long way in the right direction.

BOTTOM LINE: Memory loss can have many different causes, and these causes can and frequently do overlap.

Breaking News about ALZHEIMER's

Over 5.4 million Americans suffer from Alzheimer's dementia (AD), and we believe that an equal number of people are in the early, yet UNdiagnosed stages of Alzheimer's. If you don't know someone affected yet, you will soon. My mother battled AD for over a decade, so I have a very personal face for this disease. For the first time in nearly three decades, there are new criteria for the diagnosis of this challenging disease. What's new?

Now there are THREE stages, with the first stage existing before there is any memory loss, called PRE-Clinical AD. This is based on research settings ONLY, where levels of biomarkers can be measured. The second stage is Mild Cognitive Impairment (MCI), where there are early memory and other cognitive changes, but these developments do not significantly impair the person's ability to perform daily tasks. The final stage is Dementia, where there are not only memory, orientation and judgement difficulties, but they are to a level that affects the patient's daily life.

Biomarkers represent a very exciting FUTURE for Alzheimer's disease research and treatment. Right now, these tests are not readily available to those of us in private practice, and even if they were, we have not established solid reference points to allow for accurate interpretation of the data. The importance is THIS- just like we can measure and treat cholesterol levels BEFORE someone has a heart attack, or see rising blood sugars before full diabetes, elevated AD biomarkers may warn us of impending AD. Obviously, the next step is then to develop medications that will PREVENT the full development of dementia, if they are started during the earliest stage.

We're making progress! Go to the Alzheimer Association website and see how you can help make a difference.

BOTTOM LINE: We are learning more and more about the early stages of Alzheimer's disease, and biomarkers represent an exciting new diagnostic tool...but they are still ONLY IN RESEARCH protocols.

Can Hormone Therapy Prevent Dementia?

As our population ages and more members are developing dementia (primarily Alzheimer's), scientists are constantly on a quest to look for ways to prevent dementia. In the past, we felt the data supported that estrogen ("HRT"- hormone replacement therapy-given to women in menopause) might prevent Alzheimer's. Subsequently, the tide turned and evidence showed that not only did it not prevent, but it may worsen your risk. What do we think today?

A recently published study in the Annals of Neurology, Timing of hormone therapy and dementia: The critical window theory revisited, represents hope and a bit of a compromise. This study suggests that women who take HRT WHEN THEY BECOME MENOPAUSAL (but not later in life) have a significantly reduced risk of developing dementia!

The study was a good size- around 5500 women. Their pharmacy records were used to verify HRT use in their mid-life (average age around 49) and then evaluated again roughly 30 years later, when the women were in their late 70s and 80s. Over a quarter of these women developed dementia (27%) which may sound shocking, but is consistent with the growing incidence of dementia.

The analysis showed that women who TOOK HRT ONLY IN THEIR MIDLIFE had a 26% reduction in their risk of developing dementia compared with women who never took HRT, whereas those who took HRT only in their later life had a 48% INCREASED risk. Interesting, those women that took HRT BOTH midlife and later life had the same risk as those women who NEVER took it.

BOTTOM LINE: Current evidence-based medicine suggests that taking HRT at the time of menopause may DECREASE your risk of developing dementia, but starting HRT late in life can INCREASE your risk. Women, please factor this in when you have your discussion with your physician regarding pros and cons of HRT!

Why Visit Someone with Alzheimer's?

Please, I am BEGGING you, if you have a friend or family member with Alzheimer's disease, STAY IN CONTACT with him or her! The saddest part of my mother's Alzheimer's struggle was that many of her friends seemed to drop off the face of the earth. I understand that they were uncomfortable, worried that she might not remember them. What would they talk about? What if they brought up something she didn't remember- would that upset her or make her feel bad?

So here is the real deal. Yes, it's awkward. No one wants to see a dear friend struggle for words, or looking at you with a blank stare. On the flip side, even once someone who has dementia no longer recognizes you for the relationship you once shared, he or she still can sense the so-human link of affection. A big smile and laugh as you are "reminding" them of an old story involving the two of you will bring a moment of joy and often a real connection. Know that in the early and moderate stages, when the Alzheimer's patient no longer initiates conversation, she may still have full recall of remote events.

Pictures and music are also very powerful bonds. Think of that commercial jingle you can't shake out of your head. Similarly, old songs from the radio or traditional religious or patriotic songs pop right back into an otherwise confused brain. Simply flipping through old photo albums or singing songs can also turn on that faulty switch in their brain.

Finally, if there is a spouse, keep in touch with them as well. Pick up the phone and give them a call, and don't worry about what you are going to say. Saying ANYTHING is a million times better than nothing!

BOTTOM LINE: This Thanksgiving week, reconnect with any friends or family members who have been struggling with the non-glamorous challenge of dementia, and give thanks if your brain is still healthy!

PS. Our family is TREMENDOUSLY thankful for all the friends and family who continue to love and support first our Mom and now our Dad in their battles with Alzheimer's and Parkinson's dementias. God bless you!

Dementia- Remember THIS!

Today I am speaking at the AAFP Scientific Assembly about DEMENTIA. Why? Because I know first hand what it is like to CARE for someone with dementia, and have experienced frustrations from the family member/care giver standpoint, and I want to help other family physicians gain some insight from our family's experience. Our mother faded for twelve years from Alzheimer's, and now our father is battling Parkinson's dementia. We have the unique view from both the provider and patient aspects, and I hope my talk can make a difference.

What are a few things I want to share?
1. How to recognize what is "normal" age-related memory change versus true dementia (see Do I Have Alzheimer's?)
2. Docs need to be the "bad guy" and say it's time to stop driving. (See Driving Safely while Aging)
3. Subtraction skills are used every day- figuring out change, recipes, and even counting backwards to see what time you need to leave the house to arrive on time for an appointment. When this SKILL goes, what you SEE is trouble with those activities.
4. Pills-especially with generics, pills can LOOK ALIKE and add to confusion of poly-pharmacy. Simplify, simplify, simplify!
5. Pill delivery- all pill boxes are not created equally. Finding one that works can make a beautiful difference.
6. Stopping medications- there comes a point when it is time to stop pills aimed to prolong life (statins, aspirin, etc.) If there are no side effects to the patient quality of life to STOP them, I do.

That tops the list, and we'll see what input others have today!

BOTTOM LINE: Primary care physicians can do more to help their patients facing dementia, and I hope to help them see how!

PS It's OCTOBER FIRST- Time to change those AIR FILTERS!

Can You Smell That?

Did you know that smells provide your strongest sense of memory? A quick whiff of sunscreen make take you to childhood beach memories, hairspray back to high school, freshly baked cookies back home or perhaps a certain cologne to a special person. Yesterday, I had the pleasure of smelling "fall" as I hiked through a beautiful aspen grove, the path covered in what my daughter calls the "crunchy golden blanket" of leaves. Too bad we can't bottle up that marvelous smell of nature!

Smell might be the sense we think about the least- until there is a problem with it. Without smell, taste is muted, leading to either decreased appetite or overeating (or over-spicing!) as we try to find something to satisfy a craving. If you wonder about your sense of smell, see if you can distinguish some common smells such as cinnamon, peanut butter, vanilla, coffee or lemon.

What causes your sense of smell to decrease or disappear? Some people are simply born without a sense of smell. Most commonly, however, we see transient lack of smell (the medical term is anosmia) from nasal congestion due to colds or allergies. Smoking, of course, not only destroys taste buds, but also decreases the ability to smell. Overuse of nonprescription nasal sprays such as Afrin is another common cause. Less common are medical disorders such as zinc deficiency and hypothyroidism, and rarely loss of smell can be a sign of diseases in the frontal lobe of the brain such as tumors or dementia.

BOTTOM LINE: If you notice you can no longer distinguish smells very well (and have no obvious cause such as a cold, chronic allergies or smoking habit), it's time to head to your doctor for a check up!

World Alzheimer's Day

Today is World Alzheimer's Day, and a new report was released on Capital Hill that documents the global cost of Alzheimer's and related dementias to be more than $600 BILLION, and 70% of the costs occur in North America and Western Europe!! Dementia actually costs 1% of the entire world's GDP (gross domestic product.)

This disease affects all societies, and with our aging population, the cost is anticipated to increase drastically. "People with dementia, their families and friends are affected on personal, emotional, financial and social levels. Lack of awareness is a global problem. A proper understanding of the societal costs of dementia, and how these impact upon families, health and social care services and governments may help to address this problem."

On a personal level, my mother died after a twelve year struggle with Alzheimer's, and now my father is fading away from Parkinson's dementia. The emotional toll alone is devastating, but the financial and time consumption adds dramatically to the burden of this disease. If this illess has not affected your family or loved ones yet, be aware that chances are very high that it will. Increasing awareness of dementia should help focus more attention on research for both cure and prevention of this crippling disease.

BOTTOM LINE: Read the 2010 World Alzheimer's Report for a sobering look at the staggering costs of dementia.

How 'Bout a Cookie?

It's tough to say goodbye and leave your kids at camp- and you KNOW they are going to have a blast, make new friends and have wonderful new experiences. How much more difficult is it to move your parent into a senior community? Regardless of whether or not your parent is moving into a "senior retirement community" or assisted living, or even skilled nursing, you worry about them much like sending your child to kindergarten or summer camp. Who will they sit with at meals? Will the others be kind to them? Will they participate in activities?

I pray for patience, love and kindness in the heart of every person who works with our elderly. I hope they look at each resident and picture their own mom or dad in that situation.

When your parent has dementia, there is the extra pain that each day may bring a fresh volley of questions- when am I going "home"? Where am I? And the separation begins anew each time.

I wish I had many words of wisdom to impart about how to make this easier. What worked with my Mom (who had Alzheimer's) does not necessarily work with my Dad (who has Parkinson's dementia.) I do know that engaging your parent in a simple activity that still captures their attention- perhaps a Seinfeld episode, an old musical DVD, enjoying a favorite snack, or perhaps dialing an old friend for a short conversation- creates a pleasant diversion when it is time for you to leave. Most staff in memory units are skilled in these diversions. Ask them for help!

BOTTOM LINE: Just as you might with a child, be creative with diversions at the end of visits with your memory-challenged parent.

What's YOUR Status?

A friend shared a story today that I have heard many times before, and it bears repeating. My friend's father lives in another town. Family members have realized that he has been repeating himself a great deal, forgetting significant dates (birthdays, appointments), not paying bills and generally letting his house fall into disrepair. The family is worried about his memory. These forgetful behaviors are all new- totally out of character for this man. He went to see his doctor, and took the "mini-mental status" test, scoring nearly perfect, and so was reassured that there is no problem.

So what is the problem? The problem is that you can have fairly advanced dementia (memory loss) and STILL randomly score well on this quick memory test. Sadly, I remember that with our mom, she was still only missing a couple points when she no longer recognized that I was her daughter. The mini-mental status exam is a quick tool that is often used in the primary care setting to help us asses a patient's mental awareness and simple memory and calculating tools. If you score poorly on it, that is a huge red flag and catches our attention. The challenge for the physician is that we need to remember that this test does NOT RULE OUT dementia.

If a family is concerned and gives specific examples such as those listed above, we need to pursue further testing. In my office, that means lab work in our office a referral for full neuro-psychiatric testing.

BOTTOM LINE: A "normal" mini-mental status exam does NOT mean your memory is okay. Look at the big picture and give your doctor specific examples (write them down ahead of time) so he/she can better evaluate the seriousness of the problem.

Want to see the Mini-Mental Status test? http://www.gp-training.net/protocol/psychiatry/mini_mental_state.htm

Happy Memorial Day!

Today we celebrate the memory of all the hundreds of thousands of courageous men and women who have given their lives for our country, and for the pursuit of freedom in other countries. What an amazing gift we have received!

I wish we voted on Memorial Day, as I believe we'd have a much greater turn out...what other country freely and loudly complains about their government (local and nationally) and then doesn't show up to vote?? But I digress...

I would like to use today's theme to transition into some blog entries on MEMORY. Memory itself is an amazing gift, and one we typically take for granted until we notice something missing. Memory is not only about the past, but is the key to hope of future events as well.

Dementia- memory loss- affects over five million Americans today. As our society ages, those numbers will escalate further. If you do not have a family member or friend affected by dementia yet, you are unusual- count your blessings.

Bottom Line: Today, on Memorial Day, let's be grateful for the precious gift of memory.

Do I have Alzheimer's?

Do you forget why you walked in a room? Can't find your keys or the tv remote? Couldn't think of an old friend's name when you ran in to them at the store? RELAX- none of these episodes are unusual for a healthy, busy adult. Typically these things happen when you are stressed and simply not paying much attention to your task at hand.
What is concerning, then? Forgetting directions to the grocery store where you always shop; missing multiple appointments because you confused times/dates; being unable make change or figure out tips (when you could before) or not being able to name common objects (like a watch or a shirt.)
If you think you are having significant memory issues, please go and see your doctor! There are many causes of memory loss that are correctable, and even if you do have early Alzheimer's disease, we have good medicines that really slow the progression of disease.
CHECK OUT the Alzheimer's Association's "Ten Signs of Alzheimer's"
Bottom Line: Memory loss with Alzheimer's Disease can be distinguished from memory changes with normal aging; if you are concerned, go see your doctor!

Still Alice- a MUST READ

My mother passed away five and a half years ago after a twelve year struggle with Alzheimer's disease. Now, my father has dementia from Parkinson's disease (which for all intents and purposes looks Alzheimer's). Dementia- which means progressive memory loss- is tough on everyone. There is no "noble battle" aura like we have when people fight cancer. Friends often disappear, rather than increasing their presence. No one knows what to say. To quote my mom in a lucid moment, "It's not exactly FUN losing your mind!" Instead, our loved ones slowly, steadily slip away. It is absolutely heart-breaking.
Still Alice is a must-read for everyone, because if you don't yet have a friend or loved one suffering from Alzheimer's, odds are good that you will. Still Alice tells the story of Alzheimer's from the point of view of a young 50 year old Harvard neuropsychologist as she is diagnosed with and rapidly declines from early onset Alzheimer's. Although this is a fictional account, it is very accurate and insightful.
BOTTOM LINE: Pick up a copy of Still Alice today, read it, and pass it on.